Contractor Registration Form

Contractor Registration Form

State Certified or State Registered
Business Name*
License Holder's Name*

First NameLast Name
State License Number*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number*
Please enter a valid phone number.
License Holder Direct Phone Number*
Please enter a valid phone number.
Email*
example@example.com
PIN NUMBER*
(Four-digit number to be used as password the first time you log in. The number cannot start with a zero.)
Upload a copy of the State License*

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Upload a copy of the Liability Insurance*

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Upload a copy of the Worker's Comp Insurance or Worker's Comp Exemption*

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Upload a notarized Letter of Authorization if applicable

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NOTE: Insurance certificates need to list the City of Ocala as a certificate holder with the address listed above and must include the license holder’s state license number(s).

City of Ocala
201 SE 3rd Street (Second Floor)
Ocala, FL 34471
352-629-8421
building@ocalafl.gov
Letter of Authorization Form
Should be Empty: